課件文稿說明講稿spay neuter training en ch wwl

1Guidelinesforspay/neuterofdogs&cats

犬貓絕育指南Dr.KatiLoefflerIFAW國際愛護(hù)動物基金會Overview概述Animalhandling照料動物Pre-surgicalcare術(shù)前護(hù)理Generalclinicalconsiderations

臨床注意事項Surgery手術(shù)Post-surgicalcare術(shù)后護(hù)理2AnimalHandling照料動物Keepanimalscalm

保持動物平靜Animalsareusuallystressedandfrightened

通常動物易緊張害怕Noshouting,smoking,excessivenoiseoractivity

不要大聲叫嚷、抽煙、制造過多噪音或動作Speakquietly,behavewithcompassionandempathy

小聲說話，行為舉止充滿關(guān)愛3AnimalHandling照顧動物Keepanimalscalm

保持動物平靜Ifananimalisupsetandresisting,leaveitaloneinaquiet,darkenedplaceforafewminutesuntilithascalmeddown.Thenapproachgentlyandquietly.如果動物焦慮抵觸，將其獨(dú)自安置于僻靜昏暗處，直到它平靜下來。然后溫柔、安靜地接近。4AnimalHandling

把持動物Physicalrestraintfollowshumaneprinciples

對動物進(jìn)行身體約束時遵循人道原則Ensuresafetyofanimalsandpeople.

確保人與動物的安全Handleanimalsgentlyevenwhenonemustbefirmwiththem

盡管把持動物須確保穩(wěn)固、有力，但一定要溫和。Minimizestressanddonoharm.

施加最小壓力，拒絕傷害Neverhit,chokeorotherwiseinjureananimal

決不能擊打、掐或以其它方式傷害動物5AnimalHandling

把持動物Preventionofzoonoticdisease

預(yù)防人畜共患病Anyonewhoworkswithdogsandcatsshouldbevaccinatedagainstrabies凡為犬貓工作的人一定注射疫苗預(yù)防狂犬病WashhandsbetweenhandlingeachanimaI.Ifwearinggloves,useafreshpairforeachanimal接觸下一個動物前要重新洗手；若使用手套，要為每個動物更換新的Washhandsbeforeeatingandafterusingtoilet

飯前便后要洗手6Pre-surgicalcare術(shù)前護(hù)理Fastingpriortosurgery:

術(shù)前禁食Adults:8hours成年：8小時Youngerthan9months:4hours

小于9月齡：4小時Donotrestrictaccesstowater

勿限制喂水7Pre-surgicalcare術(shù)前護(hù)理Informownersaboutsurgery&post-operativecare;signconsentform

告知動物主人手術(shù)及術(shù)后護(hù)理；簽字同意Completephysicalexaminationwithin24hrsofsurgery–seeworksheet

手術(shù)24小時內(nèi)全面體檢—見表單8Pre-surgicalcare術(shù)前護(hù)理5.Preparerecordsforeachanimal

每個動物的記錄準(zhǔn)備Consentformtobesignedbyowner

動物主人簽字同意書Animalidentification,biographicaldata,History&physicalexamination

動物身份鑒別，傳記資料，病歷及體檢報告Anaesthesiarecordform麻醉記錄表Clinicalrecordform 臨床記錄表9Generalclinicalconsiderations

臨床注意事項Puppies&kittensmustbeatleast5monthsold幼犬、貓一定至少5月齡Aclinicalrecordwillbecompletedforeachanimal(previousslide)

完成每個動物的臨床記錄表（見前頁）10Generalclinicalconsiderations

臨床注意事項

Estrousorpregnantanimalsmaybespayedatthediscretionofthesurgeon,butownersmustbeinformedoftheadditionalrisk.

醫(yī)生可根據(jù)判斷，為發(fā)情或懷孕的動物絕育，但務(wù)必通知動物主人額外的風(fēng)險11Generalclinicalconsiderations

臨床注意事項

Surgeryshouldbedelayedorrefusedifphysicalexaminationindicatesthatsurgeryconstitutesunreasonablerisktotheanimal.

如果體檢表明手術(shù)將對動物構(gòu)成不合理危險，應(yīng)該推遲或拒絕手術(shù)。12Generalclinicalconsiderations

臨床注意事項

Alldrugsmustbelabeledwithdateopened

所有藥物需標(biāo)明開瓶使用日期Allsyringescontainingdrugsmustbelabeledwithname&concentrationofdrug

須在所有含藥物的注射器上標(biāo)明藥物的名稱及濃度Usenew,sterileneedle&syringeforeachinjection

每次注射后更換新的，無菌針頭和注射器13Generalclinicalconsiderations

臨床注意事項

Ifananimalisfoundtobeillwithaconditionthatiscausingunduesufferingandhasapoorprognosisforrecovery,itwillbeeuthanisedhumanely.

若發(fā)現(xiàn)動物傷病已導(dǎo)致其遭受過多痛苦且恢復(fù)的可能性不佳，人道地實(shí)施安樂死。14Generalclinicalconsiderations

臨床注意事項

Duringsurgery,animalsmaybepermanentlymarkedassterilized:

手術(shù)期間，給動物做持久的已絕育標(biāo)記Cats–cliptipoftheleftear.

貓咪—左耳尖端去除一小塊Bitch–notchleftear;iflong-haired,tattooinsideofleftear

母犬—左耳尖端去除一小塊；若長毛，在左耳內(nèi)側(cè)紋標(biāo)記15Anaesthesia:priortoinduction

麻醉：引入前Calculatedrugdoses

計算藥品劑量Anaestheticdrugs麻醉藥品Emergencydrugs(adrenaline,atropine,doxapram,diazepam)

急救藥（腎上腺素，阿托品，嗎啉比咯堿/多沙普侖，地西泮）Analgesics解熱鎮(zhèn)痛藥Antibiotics抗生素16Anaesthesia:priortoinduction

麻醉：引入前Knowwhattoexpectofthedrugs.

全面了解藥物Zoletil–vomiting,respiratorydepression,transienttachycardia(dogs),salivation,musclerigidity,roughrecoveries

舒泰—嘔吐，呼吸抑制，短暫的心跳加速（犬），流涎，肌肉僵硬，恢復(fù)時不穩(wěn)定Xylazine–vomiting,respiratorydepression,bradycardia

塞拉嗪—嘔吐，呼吸抑制，心搏緩慢17Anaesthesia:priortoinduction

麻醉：引入前Minimizestress!

減少壓力！Keepanimalquiet,dark

保持安靜，昏暗的環(huán)境Noloudvoices,noise,commotion;minimizepeople

不要大聲講話，噪音，騷亂；閑人免進(jìn)18Anaesthesia:priortoinduction

麻醉：引入前Endotrachealtubes:soakin4%chlorhexidineandrinsedthoroughlybetweenpatients.

氣管插管：浸泡于4%洗必泰，在每個病號使用前徹底刷洗干凈Preparewarmsurfaceonsurgerytable

在手術(shù)臺上準(zhǔn)備暖和的鋪蓋Ifpossible,placeIVcatheter條件允許，準(zhǔn)備靜脈留置針19Anaesthesia:priortoinduction

麻醉：引入前Pregnantanimals,animalspotentiallyatriskorsurgeriesexpectingtolastlongerthan30minutesmustreceiveIVfluidsduringsurgery(0.9%NaClorLRS;10ml/kg/hour)

懷孕的動物、面臨潛在危險的動物，若手術(shù)預(yù)計超過30分鐘，期間一定靜脈補(bǔ)液（0.9NaCl或LRS；10ml/kg/小時）20Anaesthesia:induction

麻醉：引入前Minimizestress(dark,quiet)

減少壓力至最?。ê诎怠察o）Ifpossible,placeIVcatheter

條件允許的話，準(zhǔn)備靜脈留置針Monitorclosely:breathing,position,CNSsigns

密切監(jiān)控：呼吸、姿勢、中樞神經(jīng)系統(tǒng)癥狀21Anaesthesia:post-induction

麻醉：引入后Checkvitalsigns

檢查生命指征Intubateimmediately

立即插管PlaceIVcatheter

準(zhǔn)備靜脈留置針22Anaesthesia:post-induction

麻醉：引入后Lubricateeyes

給眼睛抹潤滑油Administermeloxicam/carprofenandantibioticinjection

給藥：美洛昔康/卡洛芬和抗生素注射

23Anaesthesia麻醉Anaestheticmonitoring&recordsevery5minutes,beginningwithinduction–seeform

每五分鐘進(jìn)行監(jiān)控并記錄，麻醉注射時開始—見表Theanimalmustbeinasurgicalplaneofanaesthesiathroughouttheprocedure

在手術(shù)期間，保持動物的麻醉狀態(tài)24Stagesofanaesthesia麻醉階段25Stage階段Characteristics特征Laryngealreflexes

喉頭反射Respiration呼吸Jaw&tongue

下顎及舌Eyes眼睛1:Sedation鎮(zhèn)靜期Sedation,possibledisorientation鎮(zhèn)靜，定向力可能消失Swallowingreflexintact,canmaintainownairway吞咽反應(yīng)存在，氣管可自控Strongjaw&tonguetone下顎及舌緊張度強(qiáng)Drowsybutallreflexesintact昏昏欲睡但所有反應(yīng)存在2:Unconscious,Delirium無意識，昏迷LossofconsciousnessHyperresponsetostimulationIrregularrespirationVocalizationUncontrolledmovementRetching,vomiting意識喪失，對刺激反映強(qiáng)烈，呼吸無規(guī)則，發(fā)聲，不自主運(yùn)動，惡心，嘔吐Swallowingreflexintact,canmaintainownairway吞咽反應(yīng)存在，氣管可自控Irregularbutusingintercostalmuscles+Diaphragm不規(guī)則，使用肋間肌和膈控制呼吸StrongjawtoneTonguevoluntarilyretractedwhenpulled下顎緊張度強(qiáng)，將舌體拉出自主縮回PalpebralreflexpresentPupilsdilated尚有眼瞼反應(yīng)，瞳孔擴(kuò)大3:Surgical手術(shù)期NovocalizationorvoluntarymovementMusclerelaxationAnalgesia,butpainfulstimulimaycause↑HR,RR,BP無發(fā)聲或自主運(yùn)動，肌肉松弛，鎮(zhèn)痛，疼痛刺激導(dǎo)致心跳、呼吸、血壓升高Lossofswallowingreflex,mustprotectairway吞咽反應(yīng)消失，必須保護(hù)氣管Regularwithstrongchestmovement&diaphragmfunction呼吸規(guī)則，依靠胸廓強(qiáng)烈運(yùn)動及膈功能LossofjawtoneTonguerelaxed,doesnotretractwhenpulled下顎緊張度消失，舌體松弛，將舌體拉出不能自主縮回LossofpalpebralreflexPupilsfixedEyeballusuallyrotatesdownReducedlacrimation眼瞼反應(yīng)消失，瞳孔大小固定，通常眼球轉(zhuǎn)向下方流淚減少4:Medullarydepression延髓麻痹期Anaestheticcrisis:deathimminentPulseweak(BPtoolow)AdministerIVfluids&ventilationAdministerpharmacologicalstimulationofrespiratory&cardiovascularsystems麻醉危險期：死亡臨近，脈弱（血壓過低）靜脈補(bǔ)液及通風(fēng)，藥物急救：呼吸及心血管系統(tǒng)Noswallowingreflex,shouldbeintubated!無吞咽反應(yīng)，插管！Respiratoryarrest呼吸停止NojawtoneTonguerelaxed下顎無緊張感，舌體松弛NopalpebralreflexPupilsdilateCorneadry無眼瞼反應(yīng)，瞳孔擴(kuò)大，角膜干燥Monitoringsurgicalplaneofanaesthesia

監(jiān)控麻醉手術(shù)期Palpebralreflexabsentorslight(retainedwithZoletil)

無眼瞼反應(yīng)或輕微反應(yīng)（舒泰維持）Jawtone&tonguerelaxed

下顎及舌體松弛Noswallowing吞咽反應(yīng)消失Novocalization不發(fā)聲26Monitoringsurgicalplaneofanaesthesia

監(jiān)控麻醉手術(shù)期Heartrate&rhythm心率及心律Cat:100-200貓：100-200Dog:70-100狗：70-100Regularrhythm;ifsinusarrhythmia,checkpulse

節(jié)律固定；若心律不齊，檢查脈搏Peripheralpulsestrength&rate–strong&consistentwithheartbeat

周圍血管搏動強(qiáng)度及速率—強(qiáng)，與心搏一致27Monitoringsurgicalplaneofanaesthesia

監(jiān)控麻醉手術(shù)期Capillaryrefilltime<2seconds

毛細(xì)血管再充盈時間<2秒Mucousmembranecolor–pink

可視粘膜顏色—粉色Respiratoryrate&depth

呼吸頻率及深度Bodytemperature(q.15min)

體溫（每15分鐘）28Surgery手術(shù)Surgicalareaascleanaspossible–washwalls,floors,tables&othersurfaceswithdisinfectant

手術(shù)區(qū)域一定整潔—用消毒劑徹底清潔墻壁、地板及其它地方的表面Ventilationshouldnotbeblowingdust,fungalspores,etc.(airconditioner,fan)

保證通風(fēng)設(shè)備的清潔，不得吹出灰塵、真菌孢子等（空調(diào)，電扇）29Surgery手術(shù)Clip&asepticallypreparesurgicalarea

剃毛及無菌手術(shù)部位Useclippersonly(norazorbladeorchemicals).

只能用電推剪（誤用剃須刀或化學(xué)用品）Clipcarefullytoavoidskinrash

剃毛須小心避免皮膚受損患皮疹Prepwithchlorhexidineorbetadine/alcohol

準(zhǔn)備洗必泰或碘酒/酒精Avoiduseofalcoholonscrotum

切勿在陰囊表面涂抹酒精30Surgery手術(shù)Clip&asepticallypreparesurgicalarea

剃毛及無菌手術(shù)部位Females:from4cmcranialofumbilicusumbilicustopubis;laterally1-2cmbeyondteats

雌性：肚臍頂端以上4cm，臍部至恥骨前緣；乳頭旁邊1-2cmMalecats:pluckfuronscrotum(don’tuseclippers)

公貓：拔掉陰囊上的毛（誤用電推剪）Maledogs:caudalabdomen&medialthighs

公犬：腹下方及股內(nèi)側(cè)31Surgery手術(shù)Surgeons&assistantswearcleanscrubtop,cap&mask

醫(yī)生及助手須穿戴干凈的手術(shù)服，手術(shù)帽及口罩Practicesteriletechnique

進(jìn)行無菌操作32Surgery手術(shù)Surgeonsandanyonetouchingsterileareasmustscrubhandsanddistalforearmsatleast5minuteswith4%chlorhexidinepriortoglovingwithsterilegloves

醫(yī)生及其他人員必須用4%洗必泰刷洗手部及前臂至少5分鐘，配帶好無菌手套再接觸這些無菌區(qū)域33Surgery手術(shù)Useafresh,sterilesurgerypack,drapes,scalpelblade,suturematerialandglovesforeachanimal.

為每只動物配置新的無菌手術(shù)包、被單、手術(shù)刀片、縫合材料及手套34Surgery手術(shù)Coldsterilizedinstruments:

冷消毒的器具Acceptableforcastrations

去勢適用Washtoremoveallorganicmatter

清洗去除所有有機(jī)物Soakin3partschlorhexidine(4%)toonepartisopropylalcohol(70%)foratleast15minutes.

浸泡在4%洗必泰：70%異丙醇比例為3：1的溶液中至少15分鐘35Surgery手術(shù)Instrumentsthatentertheperitonealcavitymustbesterilizedbyautoclave

高壓消毒那些進(jìn)入腹腔操作的器具36Surgery手術(shù)Suturematerialmustbeabsorbablepolyfilamentormonofilament(e.g.,VicrylorPDS),withafreshsterilepackforeachpatient.

一定為每個病號準(zhǔn)備可吸收復(fù)絲或單絲（如可吸收的Vicryl或PDS纖維）及新的無菌手術(shù)包Cottonfibersuturematerialisnotacceptable

不能使用棉質(zhì)纖維的縫合材料37Surgery手術(shù)Removebothovaries,bothuterinehornsandasmuchaspossibleoftheuterinebody.

摘除雙卵巢，雙側(cè)子宮角，盡可能多的子宮體。BesurethatALLovariantissueisremoved.

確定摘除了所有卵巢組織。38Surgery手術(shù)Removebothtesticles.

摘除雙側(cè)睪丸Retainedtesticlesmustberemoved.

務(wù)必摘除殘留的睪丸組織Allstumpsandpedicleswillbedouble-ligated.

雙重結(jié)扎手術(shù)切除后的剩余部位及卵巢蒂39Surgery手術(shù)Pregnantanimalsmaybespayedbyasurgeonwithsufficientskill.

由資深醫(yī)師為懷孕動物絕育。Pregnantanimalsmustundergoacompleteovariohysterectomy(pernormalspay).

對懷孕動物必須進(jìn)行完整的卵巢子宮摘除術(shù)（每次常規(guī)絕育）Fetusesolderthan4weeksmustbeeuthanizedwithanoverdoseofanaesthetic.

對四周齡以上的胎兒注射過量麻醉藥實(shí)施安樂死

40Surgery:incisionclosure

手術(shù)：切口閉合Bitches:3or4layers:peritoneum/muscle,subcutaneous,subcuticular,(skin)

母犬：3或4層：腹膜/肌肉層，皮下組織層，表皮層，（皮膚）Queens:2or3layers:peritoneum/muscle,(subcutaneous),subcuticular

母貓：2或3層：腹膜/肌肉層，（皮下組織層），表皮層Maledogs:3or4layers:scrotum,fascia,(subcutaneous),subcuticular

公犬：3或4層：陰囊，筋膜，（皮下組織層），表皮層

41Surgery:incisionclosure

手術(shù)：切口閉合Malecats:donotsuture

公貓：不須縫合Muscle&skin:simpleinterruptedsutures

肌肉和皮膚：簡單的間斷縫合Subcutaneous&subcuticular:continuoussuturepattern

表皮及皮下：連續(xù)縫合42Post-operativecare:anestheticrecovery

術(shù)后護(hù)理：麻醉恢復(fù)期Criticaltime:beprepared

關(guān)鍵時刻：做好準(zhǔn)備RemoveETtubewhenswallowingorcoughing

當(dāng)動物吞咽或咳嗽時取出氣管插管Keepquiet,warm&dimlight

保持環(huán)境安靜，溫暖和昏暗43Post-operativecare:anestheticrecovery

術(shù)后護(hù)理：麻醉恢復(fù)期Monitoratleastevery5minutesuntilabletostand&walk

至少每5分鐘監(jiān)測一次，直到可以站立行走Giveanalgesicdrug3dayspost-operatively

術(shù)后給3天止痛藥Giveantibiotic7daysifpotentialforinfection

若感染潛在發(fā)生給7天抗生素44Post-operativecare:woundcare

術(shù)后護(hù)理：傷口護(hù)理Ownershouldcheckwoundtwicedailyforsignsofswelling,redness,dischargeordehiscence

動物主人應(yīng)該每天兩次檢查傷口，是否紅、腫、出現(xiàn)分泌物或裂開Ownershouldnottouchorwashincisionunlessinstructedtodoso

動物主人不要觸碰或清洗切口，除非